Crohn’s Disease and Dairy

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Milk and other
dairy products are excellent sources of the calcium, the mineral that everyone
needs to build and maintain strong bones. However, many people with Crohn’s
disease avoid dairy for fear that it will cause uncomfortable symptoms, such as
excess gas, abdominal cramping, and diarrhea. While it’s true that dairy can
trigger these symptoms in some people, it’s usually because they are lactose
intolerant.

People who are
lactose intolerant have trouble digesting a type of sugar known as lactose. Lactose
is found exclusively in milk and milk products. Humans are born with the ability
to break down lactose into smaller, more digestible components. This initial
step in digestion is achieved with the help of an enzyme called lactase.
Lactase is tailored to break down the lactose molecule into smaller
constituents, which are then absorbed by the intestines.

Many adults,
however, lose the ability to produce lactase. This makes it difficult for their
bodies to digest products containing lactose. As a result, people with lactose
intolerance may experience some unpleasant intestinal discomfort when they consume
dairy. The level of intolerance can vary from person to person. Some people may
consume milk and milk products in small quantities and not experience any
problems. Others may be very lactose intolerant and need to take supplemental
lactase pills to help them digest dairy products properly.

Though dairy
can cause digestive issues in people with lactose intolerance, it isn’t
necessarily something that people with Crohn’s disease need to avoid. Even if someone
with Crohn’s disease is lactose intolerant, it’s possible to safely consume
certain dairy products that contain very little lactose. These include:

yogurt

clarified butter

aged and hard cheeses, such as Parmesan
and aged cheddar

The
Elimination Diet

Dairy is often
one of the first foods that people with Crohn’s disease eliminate from their
diets. However, not every person with Crohn’s is actually lactose intolerant,
so avoiding all dairy may not be necessary. It could even be counterproductive
because dairy is an excellent source of calcium. This is a particularly
important nutrient for people with Crohn’s disease, as certain drug treatments
and malabsorption may cause a calcium deficiency.

Rather than
avoiding dairy products unnecessarily, it may be better to try an elimination
diet. An elimination diet is an approach that may help identify food allergies
or food intolerances. You keep a food journal for several weeks, taking note of
every food you eat and how you feel after eating it. You also take note of how
much of the food you ate and when you ate it.

Tracking your
progress should help you identify which foods trigger symptoms. Once you’ve
found potential triggers, remove them from your diet for anywhere from two
weeks to two months. If symptoms disappear, it can be assumed that you have an
intolerance to the eliminated food. This can be confirmed by carefully adding
the food back into your diet. If symptoms reappear, it can be assumed that the
food isn’t well-tolerated. If symptoms persist during the elimination phase, it
can be assumed that the food isn’t part of the problem, and the food can be
reintroduced into the diet.

Is
There a Link Between Dairy Farming and Crohn’s Disease?

Crohn’s
disease is believed to be an autoimmune disease that causes the lining of the
digestive tract to become inflamed. Though the exact cause for this
inflammation isn’t known, experts agree that food doesn’t play a role in
triggering it. In recent years, however, some scientists have proposed a
possible link between the dairy industry and Crohn’s disease.

Here’s why: Cows
can become infected with a microbe known as mycobacterium avium subspecies
paratuberculosis (MAP). In cows, this germ is linked to an illness known as
Johne’s disease. Like Crohn’s disease, the condition causes inflammation in the
lining of the intestines. When someone ingests beef or milk contaminated with
MAP, they can become infected with it as well. MAP is commonly found in people
with Crohn’s disease, so some scientists now speculate that MAP may be a
contributing factor to the development of the disease. While they don’t
necessarily believe that the germ causes Crohn’s disease, they argue that it
may trigger the inflammation and destruction of the intestinal lining.

The possible
link between MAP and Crohn’s disease has yet to be proven and remains very controversial.
If studies eventually do confirm the connection, the discovery could
potentially lead to better treatments for the underlying MAP infection and any
associated Crohn’s disease symptoms.